Radiation therapy is a common treatment for various cancers, including breast cancer. This treatment uses high-energy X-rays to damage cancer cells and stop them from reproducing. While effective, radiation can also affect healthy cells in the treated area, leading to side effects. This article explores whether breast radiation can cause diarrhea and provides guidance on managing this concern.
Understanding the Link Between Breast Radiation and Diarrhea
While radiation therapy specifically targeting the abdomen or pelvis frequently causes diarrhea, its occurrence with breast radiation is less common. Diarrhea can still arise due to systemic effects or if parts of the bowel are incidentally exposed to radiation scatter during treatment. The incidence and severity of diarrhea can vary based on factors like the type and dose of chemotherapy, the size of the radiation field, and the total radiation dose administered.
Radiation affects rapidly dividing cells, including those lining the gastrointestinal (GI) tract. When these cells are damaged, it can lead to inflammation, a condition known as radiation enteritis. This inflammation can disrupt the bowel’s ability to absorb water and electrolytes, resulting in increased bowel movements and loose, watery stools.
Although direct bowel irritation is less typical with isolated breast radiation, it can occur, especially if the radiation field extends close to the abdomen or if concurrent treatments like chemotherapy are administered. Chemotherapy agents commonly cause diarrhea, affecting 50% to 80% of women undergoing such treatment for breast cancer. This combined effect can heighten the likelihood and severity of gastrointestinal symptoms.
Individual sensitivity to radiation also plays a role in who experiences diarrhea and its severity. The onset of diarrhea, if it occurs, typically begins a few weeks into treatment or, in some cases, after a short course has concluded.
Managing Diarrhea During Breast Radiation
Managing diarrhea during breast radiation involves dietary adjustments to help soothe the digestive system. Eating small, frequent meals, rather than three large ones, can reduce the burden on your digestive tract. A bland, low-fiber diet, often called the BRAT diet (bananas, rice, applesauce, and toast), can be beneficial.
Avoid foods that can aggravate diarrhea. These include:
Greasy, fried, or spicy foods
High-fiber items like raw vegetables, whole grains, beans, and dried fruits
Dairy products
Caffeine and alcohol
Very hot or cold drinks
Some individuals find that incorporating soluble fiber, found in foods like oatmeal and boiled potatoes, can help absorb fluid and ease diarrhea.
Maintaining adequate hydration is important to prevent dehydration. Patients should aim to drink 8 to 10 glasses of non-caffeinated fluids daily, including water, clear broths, and electrolyte-rich beverages like sports drinks or oral rehydration solutions.
Over-the-counter anti-diarrheal drugs like loperamide may be recommended, but consult a healthcare provider before taking any medication. For discomfort in the anal area due to frequent bowel movements, gentle perineal care, such as using moist cloths or petroleum jelly, can help manage irritation. Diarrhea is typically a temporary side effect that improves once radiation treatment concludes, though it may take several weeks to fully resolve.
When to Seek Medical Attention
Patients undergoing breast radiation should contact their healthcare team if they experience persistent or severe diarrhea, including more than 4 to 6 loose stools per day. Any significant change in bowel habits warrants discussion with the oncology team.
Signs of dehydration, such as dizziness, decreased urination, extreme thirst, or a dry mouth, require prompt medical attention. Diarrhea accompanied by other concerning symptoms, including fever, chills, severe abdominal pain, or blood in the stool, also requires immediate contact with a healthcare provider.
If home management strategies, such as dietary adjustments and hydration, do not improve diarrhea, inform the medical team. This also applies if diarrhea significantly impacts daily activities or overall quality of life. Open communication with the oncology team is encouraged for managing any side effects.